Woodrats of the genus Neotoma are an important study system for ecological and paleoecological research. However, paleontological studies are often hindered by the difficulty of identifying woodrat remains to species. We address this limitation by using 2D landmark-based geometric morphometrics to classify 199 lower first molars (m1s) of five extant western North American Neotoma species (N. albigula, N. cinerea, N. fuscipes, N. lepida, and N. macrotis) collected throughout California. We then use discriminant analysis of principal components (DAPC) models to identify Late Pleistocene fossils of unknown species from the Rancho La Brea Tar Pits in Los Angeles, California. DAPC correctly identifies ∼85–90% of extant individuals to species, with most misclassifications occurring between sister taxa N. fuscipes and N. macrotis. Most fossil m1s are classified as N. macrotis by DAPC, which may be the first confirmation of N. macrotis in the fossil record. We show that landmark-based geometric morphometric analyses are generally effective at differentiating m1s of extant Neotoma species in California and they are an auspicious method for unknown fossil identification. Further applications of this method across a broader range of geographic locations and species will better contextualize its utility.

In the early 2000s, Ramakrishna asked the question: for the elliptic curve

\[E\;:\; y^2 = x^3 - x,\]

$a_p(E)$

$E/\mathbb{Q}$

We prove a Poisson process approximation result for stabilising functionals of a determinantal point process. Our results use concrete couplings of determinantal processes with different Palm measures and exploit their association properties. Second, we focus on the Ginibre process and show in the asymptotic scenario of an increasing observation window that the process of points with a large nearest neighbour distance converges after a suitable scaling to a Poisson point process. As a corollary, we obtain the scaling of the maximum nearest neighbour distance in the Ginibre process, which turns out to be different from its analogue for independent points.

In recent years, the removal of orbital debris has become an increasingly urgent task due to advancements in human space exploration. Capturing space debris through caging manipulation offers notable advantages in terms of robustness and controllability. This paper proposes a configuration-based caging manipulation design method for a cable-driven flexible arm. First, the cable-driven flexible arm with multi self-lockable links is introduced. To quantify the caging configurations formed by different self-lockable link selections, a novel planar caging quality metric is then presented for arbitrary planar objects. Using this metric, a caging design method is developed for the flexible arm to conduct caging manipulations. Finally, the caging manipulation strategies are discussed with lock selection maps for different objects, and a robust caging strategy considering uncertainty is further explored. Simulation and experimental results validate the effectiveness of the proposed caging design method and demonstrate better performance compared to conventional caging methods.

Background: Normalized growth curves are an essential component in management of pediatric patients. Benign enlargement of subarachnoid spaces (BESS) is a common condition in infants that results in deviation from expected head growth but does not have long term implications. Differentiating BESS from pathological conditions is critical to minimize unnecessary imaging and specialist evaluations. Standardized growth charts specific to BESS do not exist, complicating monitoring and management. Methods: An analysis of head circumference (HC) data was performed for 315 children aged 0-6 years diagnosed with BESS at CHEO. Growth charts were created using Generalized Additive Models for Location, Scale, and Shape (GAMLSS). Z-scores derived from HC measurements were compared to World Health Organization (WHO) norms, stratified by sex. Results: Benign macrocephalic patients consistently tracked above the 97th percentile of WHO curves, with the 50th percentile in this cohort aligning with the 97th percentile of WHO data. HC growth accelerated in early infancy, stabilizing around ages 2-3. Growth charts demonstrated distinct patterns for BESS compared to normative data. Conclusions: This study provides novel charts for BESS, enabling improved monitoring and clinical management. These charts have the potential to reduce unnecessary imaging and specialist referrals, alleviating anxiety for caregivers and clinicians while optimizing resource use.

This project aims to identify and explain a phenomenon I call pain-related motivational deficit, which occurs when there is proper uptake of the epistemic contributions of a pain utterance, but defective uptake of the motivational contributions of a pain utterance. I argue that the normalization of fibroid pain in Black women, and of menstrual pain more broadly, causes a pain-related motivational deficit to be unfairly assigned to utterances about these pain experiences. I show that current ways of thinking about epistemic injustice cannot adequately explain these cases.

After dispensing major precedents affecting the public’s health in each of its prior three terms, the 2024-2025 term of the US Supreme Court was arguably less impactful amid several unanimous decisions preserving existing jurisprudence (at least in part). However, this is an understatement. While the Court issued key decisions arguably favorable to communal health this prior year it also denied minors access to medical procedures sought by their doctors, diminished diversity, equity, and inclusion (DEI) initiatives in employment, allowed states to deny health providers access to Medicaid because they also provided abortions, disallowed rural hospitals from collecting specific costs for treating low-income patients, and provided a “script” of sorts for executive control of federal health advisory committees.

Background: Aplasia Cutis Congenita is a rare congenital abnormality characterized by varying absence of skin and mesodermal tissues. Management remains controversial, with significant inconsistency across specialties and over time. This review evaluates trends in management based on journal specialty and publication epoch. Methods: A review of pediatric scalp Aplasia Cutis Congenita management was conducted. Articles were categorized by journal type (neurosurgery, plastic surgery, dermatology, other medical, and other surgical) and management approach (surgical, conservative, or combined). Descriptive statistics were used to summarize trends in recommendations, and assess associations between journal type and treatment. Trends over time were analyzed based on publication year. Results: A total of 171 studies were included. Among surgical journals, 33.7% recommended surgical management, while medical journals favored conservative (14.1%) or combined approaches (84.5%) (p < 0.001). Recommendations for surgical management decreased from 80% in the 1970s to 30% in the 2020s. Notably, among 119 studies advocating for a combined approach, only 27 provided criteria for surgical indications, with lesion thresholds ranging from >1cm to >15 cm. Conclusions: This study highlights the lack of guidelines for ACC management and reveals specialty and time epoch of publication-dependent biases in treatment. These findings emphasize the need for multidisciplinary guidelines for consistent, patient-centered care.

A local food-based approach, including school lunch with multiple-micronutrient fortified biscuits (MMB) as supplementary snacks, may enhance dietary adequacy, although current evidence remains limited. This study assessed nutrient inadequacies and developed food-based dietary recommendations (FBR) incorporating school lunch from the Ghana School Feeding Programme (GSFP) and MMB. Data from 292 girls aged 10–17 years, enrolled in the Ten2Twenty-Ghana study was analysed. Dietary intake was assessed via a quantitative 24-h dietary recall. Usual intakes were estimated using the National Cancer Institute method. Linear programming with Optifood was used to develop FBRs based on commonly consumed foods (≥5% of participants) and their median serving sizes, intake frequency, nutrient content, and cost per 100 g. Constraints included estimated energy needs and harmonised average nutrient requirements. The mean usual energy intake was 2351 (sd 66) kcal/d. Ca (99·8 %), vitamin B12 (99·8 %), riboflavin (96·2 %), vitamin A (91·5 %), vitamin C (87·6 %), Fe (73·7 %), folate (49·3 %) and Zn (8·5 %) inadequacies were prevalent. Optimised diets achieved adequacy for protein and most micronutrients, except Ca and vitamin B12, besides vitamin A for 15–17-year-old girls. School lunch from the GSFP did not enhance micronutrient levels when added to the daily diet. Adding MMB to the daily diet ensured adequacy for vitamin C, riboflavin and Fe, although marginal for Fe. Ca and vitamin A improved substantially with MMB for girls aged 15–17 but remained below the harmonised average requirements. Integrating regular school lunch with specialised fortified foods may be a cost-effective strategy to enhance dietary adequacy for adolescent girls in rural areas.

Background: Minimally invasive endoscopic techniques via the transorbital approach (ETOA) is emerging as an alternative approach for addressing skull base tumours. This study aims to showcase our institution’s 8 year experience in using ETOA, detailing the surgical technique employed and presenting comprehensive patient outcomes. Methods: A retrospective analysis was conducted on data from 32 patients who underwent ETOA within the past eight years. Demographic data was obtained as well as information on surgical approaches, intra-operative findings, recurrence and complications. Results: 33 ETOA procedures were performed on 29 patients, with an average age of 45, 14 of whom were women. The superior orbital corridor was utilized in 100% of cases, and in 79.17%, ETOA was complemented by a transnasal approach. Spheno-orbital meningioma accounted for the most common surgical indication (36.36%, n=12, followed by lateral frontal sinus mucocele (18.75%, n=6). The median length of stay was one day.Transient V1 numbness was the primary complication (33%, n=8), and 18.75% (n=6) necessitated another surgery. Notably, no mortality was associated with this procedure. Conclusions: Our institution’s experience underscores the notable safety and effectiveness of ETOA, The main complications being transient V1 numbness, proptosis, transient diplopia. Revision surgery was only required in 6 out of 33 cases.

Background: Nipocalimab (a fully human, effectorless anti-neonatal Fc receptor (FcRn) monoclonal antibody) may ameliorate gMG disease manifestations by selectively targeting FcRn IgG recycling and lowering IgG, including pathogenic autoantibodies in generalized myasthenia gravis (gMG). The objective was to evaluate the effectiveness and safety of intravenous nipocalimab added to background standard-of-care therapy in adolescents with gMG. Methods: Seropositive patients (12-<18 years) with gMG (MGFA Class II-IV) on stable therapy but inadequately controlled, were enrolled in a 24-week open label study. Nipocalimab was administered as a 30 mg/kg IV loading dose followed by 15 mg/kg IV every 2 Weeks. Results: Seven adolescents were enrolled; 5 completed 24-weeks of dosing. The mean(SD) age was 14.1(1.86) years; seven were anti-AChR+, six were female. Mean(SD) baseline MG-ADL/QMG scores were 4.29(2.430)/12.50(3.708). Nipocalimab showed a significant reduction in total serum IgG at week-24; the mean(SD) change from baseline to week-24 for total serum IgG was -68.98%(7.561). The mean(SD) change in MG-ADL/QMG scores at week-24 was -2.40(0.418)/-3.80(2.683); 4 of 5 patients achieved minimum symptom expression (MG-ADL score 0-1) by week-24. Nipocalimab was well-tolerated; there were no serious adverse events. There were no clinically meaningful laboratory changes. Conclusions: Nipocalimab demonstrated efficacy and safety in this 6-month trial in seropositive adolescents with gMG.

Background: Predicting neurological recovery in patients with severe brain injury remains challenging. Continuous EEG monitoring can detect malignant patterns but is resource-intensive, and its role in long-term functional outcome prediction is unclear. This study evaluates the utility of parameterized short-segment EEG, acquired via EEG cap, in predicting neurological recovery. Methods: We analyzed short-segment high-density EEGs from 42 patients in the NET-ICU cohort with acute neurological injury. EEGs were pre-processed into standard clinical formats and parameterized using five visual EEG features associated with outcome prediction. Random Forest Classifier (RFC) models were trained and cross-validated to predict recovery of responsiveness (following 1-2 step commands during or after ICU admission) using: EEG features alone; clinician prediction combined with EEG features. Results: EEG-based prediction outperformed clinician bedside assessment (AUC ROC: 0.80 vs. 0.67) under the RFC model. Combining clinician Glasgow Outcome Scale–Extended (GOSE) scores with EEG features improved overall predictive performance (AUC ROC: 0.91). Conclusions: Standardized EEG features obtained using EEG caps can improve the accuracy of neurological recovery predictions in patients with acute severe brain injury. This suggests that automated extraction of background brain signals has the potential to provide clinically meaningful prognostic information in critical care settings, enhancing accessibility and resource efficiency.

Background: The consistency of effects of lemborexant (LEM), a dual orexin-receptor antagonist, on sleep maintenance variables across 2 phase 3 studies with contrasting populations was compared. Methods: E2006-G000-304 (Study 304; NCT02783729) and E2006-J086-311 (Study 311; NCT04549168) were 1-month, randomized, double-blind, placebo (PBO)-controlled studies evaluating LEM 10mg (LEM10) in adults with insomnia disorder. Global Study 304 (N=1006; PBO, n=208; LEM10, n=269) enrolled participants of any race (≥55y); Study 311 (N=193; PBO, n=100; LEM10, n=93) participants were exclusively Chinese (≥18y). Pairs of polysomnograms were conducted at baseline and after the first/last 2 doses of the 1-month treatment. Change from baseline in sleep efficiency (SE [%]), wake-after-sleep-onset (WASO [min]), and total-sleep-time (TST [min]) were analyzed. Results: Mean baseline sleep parameters: Study 304: SE, 67.9–68.9; WASO, 111.8–114.8; TST, 325.1–330.7; Study 311: SE, 69.4–70.3; WASO, 79.3-–85.8; TST, 333.2–336.7. Least squares mean [standard error] increases from baseline were significantly larger with LEM10 vs PBO (P<0.001) for SE (Study 304, 8.0 [0.7]; Study 311, 7.1 [1.4]) and TST (38.9 [3.7]; 32.8 [6.9]), as were decreases in WASO (-25.4 [3.1]; -17.8 [4.8]). Most treatment-emergent adverse events were mild–moderate. Conclusions: Short-term LEM10 treatment consistently improved objective sleep maintenance in patients with insomnia of different races.

Background: This study aimed to assess the clinical features, Electroencephalography (EEG) findings, and brain imaging results in psychiatric patients diagnosed with epilepsy at Razi Psychiatric Hospital. Methods: This retrospective descriptive-analytical study was carried out on patients with epilepsy and psychiatric disorders admitted to Razi Psychiatric Hospital over two years. A total of 94 patient files seizure and epilepsy comorbidity, recorded in the hospital’s health information system (HIS), were reviewed. Data collection involved a demographic checklist and an epilepsy scale; the latter, developed by DiIorio, Colleen, et al., encompassed personal characteristics, mental disorders, epilepsy, and seizures. The Kruskal-Wallis and MannWhitney non-parametric tests were utilized to compare the mean scores of variables, with SPSS software, version 21 facilitating the analysis Results: Out of 94 patients with seizure and epilepsy, 9.6% had focal seizure, 26.6% had generalized epilepsy, 36.1% had focal-generalized seizure, and 26.8% had unknown seizure. About 12% had a structural etiology, while the remaining 88% had an etiology that remained unidentified. Conclusions: The findings indicate that epilepsy, affecting individuals from adolescence through to old age, can lead to psychiatric disorders. For many patients, the etiology of their condition remains elusive, and EEG findings and brain imaging appear normal in the majority of cases